| NPI | 1881718294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 773-124) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15321-132) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2010-11-29 |